Authors: S Christensen F Mehnert R D Chapurlat J A Baron H T Sørensen
Publish Date: 2010/10/13
Volume: 22, Issue: 6, Pages: 1773-1779
Abstract
Bisphosphonates have been associated with an increased risk of atrial fibrillation and may thus be associated with an increased risk of ischemic stroke This would have substantial clinical and public health implications We found no evidence of an association between bisphosphonate use and risk of ischemic strokeWe conducted a populationbased case–control study of 6257 female cases of ischemic stroke and 31285 age and gendermatched population controls Data on bisphosphonate use other medication use comorbidity and ischemic stroke were obtained from medical databases Current bisphosphonate use was defined as at least one redeemed prescription within 90 days before diagnosis/index date We estimated the odds ratio OR of ischemic stroke among users and nonusers of bisphosphonates using conditional logistic regression controlling for potential confounding factorsOne hundred eightytwo 29 cases and 901 29 controls were current users of bisphosphonates Etidronate and alendronate were prescribed with similar frequency among cases and controls The adjusted OR of ischemic stroke for bisphosphonate users compared with nonusers was 097 95 confidence interval CI 082–115 New and continuing bisphosphonate users had adjusted ORs for ischemic stroke of 116 95 CI 069–196 and 097 95 CI 081–116 respectively Excluding patients with known atrial fibrillation/flutter yielded an OR of 100 95 CI 085–119 The OR for ischemic stroke was 059 95 CI 032–109 among patients with a history of previous hospitalization for cardiovascular disease and 107 95 CI 088–118 among those without P 0001 The OR for former users was 123 95 CI 101–149
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